Archive for November, 2009

Deepak Chopra has made a career out of misunderstanding quantum mechanics (QM) – and through his popularity, confusing the public. Like many others, he has found a superficial way in which to interpret quantum mechanics to make is seem as if it is congruent with Eastern metaphysics.

And now he has done it again, in that anti-science rag the Huffington Post. Chopra goes beyond the typical New Age distortion of QM, which is basically the claim that QM is really weird, therefore magic is real. Chopra assumes some very specific, and common, misinterpretations of QM. He writes:

Quantum physics tells us that objects exist in a suspended physical state until observed, when they collapse to just one outcome — we don’t know what happens until we investigate, and our investigation influences that reality. Whether or not certain events may have happened some time ago, may not actually be determined until some time in your future — it may actually be contingent upon actions that have not yet taken place.

Chopra is referring to the wave-particle duality of matter, quantum entanglement, and the uncertainty principle – but he gets them profoundly wrong. First he makes the common mistake of interpreting the collapse of the wave function as being dependent on an observer, which is false. QM states that light, electrons, and all fundamental particles exist not as discrete point particles, but spread out like a wave. We can only describe the probability that they will be in a specific place at any moment, and that probability is the wave function. Particles, when free from interactions with other matter, actually behave like waves (see the double slit experiments).

The holy grail of modern neuroscience, and perhaps one of the toughest scientific problems we face, is understanding at a fundamental level the nature of consciousness. What is it about our brain function that makes us aware of our own existence?

It is not simply an emergent property of having enough neurons wired together. A popular notion in science fiction is that artificial intelligence may unexpectedly emerge out of a sufficiently powerful computer – such as Vger or SkyNet. But this scenario is highly unlikely. Consciousness appears to be a specific function of thinking systems, not just a consequence of complexity.

For example, the cerebellum is a specialized part of the brain involved with motor coordination. It contains about the same number of neurons and connections that the cortex does, but the cerebellum itself is not conscious nor does it appear to contribute to consciousness.

Politics is partly about setting priorities and agendas, and therefore it is impossible to keep politics out of science. Politicians are also in control of the public’s purse strings, and so funding science also cannot be free from politics.

But ideally we should have an atmosphere in which politicians and funding agencies set broad agendas, and then let scientists decide the details of which research should be funded based upon the science. It is, in fact, an important trust that public money that is spent on scientific research be utilized optimally, and not to promote someone’s narrow ideological agenda. Examples of abuses are legion; my favorite example is the National Center for Complementary and Alternative Medicine (NCCAM), Senator Tom Harkin’s pet project in which the usual standards of medical research have been subverted to promote sectarian medicine.

We want scientists to follow their noses – to research those questions they think are most fruitful. But scientists are often forced to follow the funding, and this distorts the direction of research. Industry funding distorts research in ways that are advantageous to industry – a real problem that is being examined and there are at least attempts to deal with it. Government funding should be neutral, and provide a counterbalance to industry funding, but is often subverted to ideology. Even well-meaning patient-groups can distort funding if they try to dictate what scientists should be researching in exchange for their fund-raising, with detrimental effects.

The moon hoax – the claim that the US never sent people to the moon but rather executed a ridiculously elaborate hoax – persists as a monument to human cognitive frailty.

In some surveys as many as 25% of respondents doubt the Apollo missions to the moon ever happened.

It is a spectacular demonstration of the human ability to form beliefs for ideological or emotional reasons – or just out of certain habits of thought – which not only are not based upon the evidence, persist despite the evidence.

Memory is a fascinating area of neuroscience research. It is a classic tale of science in that we are in the middle of putting the pieces to the puzzle together. There are competing theories as to how human memory is constructed, and new research is adding data all the time. I find it particularly interesting because it is an example of the brain trying to understand itself. We all have a brain, we all use our memory, and therefore can relate to this research on a very personal level.

Like much of neuroscience, early knowledge of how memory works comes from dramatic cases of brain injury, from stroke or other causes. With regard to memory a number of cases demonstrated an apparent disconnect between short term memory and long term memory, and so this became the classic view. The most dramatic cases are those of Werkincke-Korsakoff syndrome in which long term nutritional deficits of thiamine, usually in alcoholics, damage the mammillary bodies – small structure in the brain involved in memory. This results in a disconnect between short term memory and long term memory – so patients have about a three minute window of short term memory but form no new long term memories. They are forever living in the past, in a brief window of memory.

For me, it is far better to grasp the Universe as it really is than to persist in delusion, however satisfying and reassuring.
– Carl Sagan

Since I started blogging I have written about Carl Sagan on or about his birthday – November 9th. This year Sagan would have been 75 years old – we definitely lost him far too soon.

Sagan remains an important figure to the skeptical movement for various reasons. He made it popular to popularize science, and simultaneously showed us how it’s done. He condemned pseudoscience without seeming dismissive or judgmental. He emphasized the wonder and awe of science with poetry and power. And he had a way of forcing you to step back and take a broader perspective on the nature of things.

His signature series – Cosmos – was a breakthrough, in my opinion. What separated that series from what was (and unfortunately often still remains) the standard in science documentaries was the way in which Sagan constructed the stories of science as a personal journey. It became our personal journey as we followed Sagan through the Cosmos. Most science documentaries are constructed of talking heads looking off camera, voice overs, and graphics. In Cosmos, Sagan was talking directly to us. He was taking us gently by the hand and leading us on an adventure of discovery.

I have been blogging this week about the Desiree Jennings case – the 25 year old woman who is telling the media that she developed a neurological disorder known as dystonia two weeks following a seasonal flu vaccine. However, the video of her movement disorder that was made public was not, in fact, consistent with the diagnosis of dystonia or any organic movement disorder, and therefore it is highly unlikely that her symptoms were a vaccine reaction. Every movement disorder specialist or neurologist who viewed the videos and voiced their opinion agreed that the signs she was displaying on the public video were most consistent with a psychogenic movement disorder.

We were also careful to point out that this does not mean she is “faking”, that her symptoms are not real, and that she is not suffering from a genuine and debilitating disorder. Simply that the nature of the disorder is likely psychogenic and not due to any specific brain pathology, caused by a vaccine or anything else.

Jennings claimed, however, that her doctors at Johns Hopkins diagnosed her with dystonia and concluded it was from the vaccine. We have only her word to take for this as her doctors, understandably (given the rules of confidentiality) have not made any public statements. Jennings could give them leave to do so, but apparently hasn’t.

As the health care debate rages in Washington, one of the fears is that the behemoth bills that are being passed around might contain hidden provisions that can cause great mischief. While there is a sense of urgency about passing a bill (any bill) there is something to be said for taking the time to pick over the details of such important policy.

Case in point – Senator Orrin Hatch (R-Utah) has slipped in a provision to the bill that would require reimbursement for prayer services. Although not mentioned by name, it is thought that the provision is aimed at Christian Science prayer. Christian Scientists, based upon the teachings of Mary Baker Eddy, do not believe in medicine – because they do not believe in illness – because they do not believe in reality. We are purely spiritual beings, they believe, and physical reality is all an illusion, and therefore all illness is as well and is really just a crisis of faith. Therefore prayer and faith is all that is needed. Seeking medical attention is actually a failure of faith and will lead to illness or death (one wonders why any Christian Scientist needs to wear glasses, then). This philosophy worked very well for Eddy, right up until the point where she died.

Christian Scientists have been tireless in promoting their spiritual prayer as legitimate medical interventions for years. They have pressured some private insurance companies to reimburse for their prayers, although this trend has reversed recently with managed care. They have also lobbied for state laws to protect their practitioners from being prosecuted for practicing medicine without a license. Worst of all, they successfully lobbied the Federal government to cover Christian Science prayer for military personnel. Now they are at work trying to exploit health care reform to further their agenda. The LA Times reports:

The spiritual healing provision was introduced in the House by Rep. John Shimkus (R-Ill.), whose district includes a Christian Science school, Principia College.

The measure is also supported by Senator John Kerry and the late Edward Kennedy – both senators from Massachusetts, home of the headquarters of the church.

The recent discussion of the Desiree Jennings case has prompted speculation and misinformation about the nature of psychogenic illness. I therefore thought it would be useful to discuss the concept of psychogenic illness in general. The following is cross-posted also at Science-Based Medicine.

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I have never used those words to a patient or about a patient. I have also never heard a colleague use any similar term to a patient. And yet on many occasions I have had patients ask me, “So you’re telling me it’s all in my head?”

The concept of what are now called psychogenic symptoms is a tricky one for various reasons. There is an unfortunate stigma attached to the notion that our brains can cause physical symptoms. Making the diagnosis is complex. Outcomes are variable and are hampered by the difficulty in communicating the diagnosis to patients. Psychogenic symptoms often mask underlying physiological disease. And the risks of both false positives and false negatives are high.

This complexity leads some to argue, in essence, that psychogenic symptoms do not exist at all – that the diagnosis is a cop out, a way to blame the patient for the failings of the physician. But this approach, ironically, is a cop out, because it seeks to white wash what is a real and complex disorder with an overly simplistic and moralistic approach.

Yes, I know – it’s the Daily Mail. My UK friends tell me this is little more than a rag, not to be taken seriously. But it’s popular enough, and may in fact represent the attitudes of a portion of the public, that sometimes we have to address the claims that are made there. In that way it is like the Huffington Post – a hopeless rag (at least when it comes to science) that sometimes needs a response.

This time the Daily Mail has published an incredible anti-science and anti-intellectual rant by reporter Andrew N Wilson. The article is a discussion of the firing of science adviser, David Nutt, over his recommendations regarding recreational drugs. The Guardian did a decent job of covering the controversy – but also had the moxy to run the headline – “David Nutt Sacked.” Perhaps that does not mean the same thing in the UK as it does in the US – which is hilarious.

There are two issues here – the question of drug policy and how it should be informed by science, and the incredible reaction of Wilson. Interestingly, I find myself siding (just a bit) with Wilson on some points, in that there is a kernel of truth to be had in his screed. Here’s the controversy in a nutt shell. David Nutt produced a report comparing the risks to individuals and society of various substances, including tobacco, alcohol, marijuana, and ecstasy. He concluded that the risk from the legal substances far outweighs the risk from the illegal ones.